| NPI | 1104128743 |
|---|---|
| Other Name | LAKES AREA PAIN AND REHAB |
| Entity Type | Organization |
| Authorized Contact | CRAIG ANTHONY CHARLESTON Partner 409-892-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2010-12-02 |